Comparison of Transcatheter Atrial Septal Defect Closure in Children, Adolescents and Adults: Differences, Challenges and Short-, Mid- and Long-Term Results

Turkay Saritas,Ilker Kemal Yucel,Ibrahim Halil Demir,Fadli Demir,Abdullah Erdem,Ahmet Celebi 대한심장학회 2016 Korean Circulation Journal Vol.46 No.6

Background and Objectives: This study aims to compare the characteristics, effectiveness and results of transcatheter closure of atrial septal defect between children, adolescents, and adults. Subjects and Methods: In this study, 683 patients who underwent atrial septal defect closure in the last 10 years were divided into three groups: children (age <12), adolescents (age 12 to 16), and adults (age >16) as group 1, group 2 and group 3, respectively. Results: The average defect size and incidence of complex atrial septal defect were higher in group 3 (p=0.0001 and 0.03 respectively). While the average size of the devic was higher in adults (22.6±6.4 mm vs. 18.5±4.9 mm; p=0.0001), the ratio of the device size/total septum was higher in both children and adolescents (Group 1 and 2). In the child and adolescent groups and patients with only complex atrial septal defect, the use of techniques, other than standard deployment, was similar in all three groups (p=0.86 and 0.41, respectively). The ratio of the residual shunt was similar in all three groups. Major complications were seen in 5 cases (4 cases with migration, and 1 case with dislocation) in group 3 and 1 case (migration) in group 1. Conclusion: Depending on the complexity of the defect and age of the patient, transcatheter closure of atrial septal defect might have certain difficulties and complications. Patients must be evaluated in detail to avoid major complications and possible problems during the procedure.

Characteristics of patients operated for primary hyperparathyroidism at university hospitals in Türkiye

Turkay Kirdak,Nuh Zafer Canturk,Nusret Korun,Gokhan Ocakoglu 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.91 No.1

Purpose: The aim of this study was to define the clinical and laboratory characteristics of patients operated on for primary hyperpatathyroidism (PHPT) at university hospitals in Türkiye, and to investigate the differences in the clinical presentations of the disease between different geographical regions. Methods: Patients operated on for PHPT in the university hospitals of Türkiye were included in the study. The demographic, clinical, and laboratory findings and the operational data of the patients were investigated according to the whole country and to different geographical regions. Comparisons were performed according to whole country and regions. Results: A total of 1,162 cases were included in the study from different regions and 20 university hospitals. The mean age of patients was 52.4 ± 0.38 (mean ± standard error) in the general population of Türkiye. The rates of hypertension, urolithiasis, bone disease and 25-hydroxyvitamin D insufficiency were 35%, 18.6%, 67.6%, and 63%, respectively. The median parathormone (PTH), serum total calcium (Ca<SUP>+2</SUP>) and phosphorus value were 220 pg/mL (range, 70–2,500 pg/mL), 11.2 mg/dL (range, 9.5–11.2 mg/dL), and 2.4 mg/dL (range, 1–4.7 mg/dL), respectively. The median size of the adenomas resected was 16 mm (range, 4–70 mm). Significant differences were observed in the clinical and laboratory findings of the patients operated on due to PHPT between different geographical regions of Türkiye (P < 0.05). Conclusion: The clinical and laboratory characteristics of the patients with PHPT in different geographical regions of Türkiye differ. Furthermore, the general findings of the cases in Türkiye give us a hint that the severity of the disease here is somewhere between Eastern and Western countries.

Road Profile Modeling by Subspace Identification Methods

Semiha Turkay,Huseyin Akcay 제어로봇시스템학회 2015 제어로봇시스템학회 국제학술대회 논문집 Vol.2015 No.10

In this paper, spectral models of road profiles using nonparametric and subspace identification methods are developed from road elevation measurements. First, power spectra of road profiles are estimated on uniform grids of frequencies by averaging and windowing from road measurements. These results are illustrated on the data sets obtained from the University of Michigan Transportation Research Institute archives by computing Welch spectrum estimates for left and right vehicle tracks. Then, curve fitting by the single and two-slope approximations are applied on the Welch estimates. Rational approximations, by considering a recent subspace algorithm, the regularized nuclear norm and the regularized and reweighted nuclear norm heuristics are performed for a further shaping of power spectrum estimates. Preliminary results show that the regularized and reweighted nuclear norm heuristic algorithm yields best fits to the data by low order rational spectra without distorting too much the homogeneous road assumption. Finally, for comparision of the roughness evaluation the IRI roughness index is calculated for different algorithms assuming that road excitations are zero-mean Gaussian processes.

Multi-Objective Design for Half-Car Active Suspensions

Semiha Turkay,Huseyin Akcay 제어로봇시스템학회 2012 제어로봇시스템학회 국제학술대회 논문집 Vol.2012 No.10

In this paper, multi-objective control of a half-car suspension system is formulated as a mixed H2/H∞ synthesis problem and this convex problem is solved using linear matrix inequalities. Then, the control design problem is re-formulated as a non-convex and non-smooth optimization problem with fixed order controllers and solved by using the recently developed HIFOO toolbox. Parametric studies show that tire damping can seriously impact closed-loop performance of actively controlled half-car models.

Acute Lymphoblastic Leukemia Presented as Multiple Breast Masses

Ilkay Koray Bayrak,Turkay Yalin,Zafer Ozmen,Tolga Aksoz,Roula Doughanji 대한영상의학회 2009 Korean Journal of Radiology Vol.10 No.5

Breast metastases in cases leukemia are very rare and occur primarily in patients with acute myeloid leukemia. We report the involvement of breast metastases in a 30-year-old woman with acute T cell lymphoblastic leukemia. The patient’s mammograms revealed an extremely dense pattern with ill-defined, denser mass-like lesions in both breasts. A bilateral breast ultrasonographic evaluation revealed lobular-shaped and partly ill-defined hypoechoic masses with a multi-septated nodular (mottled) appearance.

Paracetamol degradation and kinetics by advanced oxidation processes (AOPs): Electro-peroxone, ozonation, goethite catalyzed electro-fenton and electro-oxidation

Hazal Ozturk,Sibel Barı?cı,Ozge Turkay 대한환경공학회 2021 Environmental Engineering Research Vol.26 No.2

The advanced oxidation of paracetamol (PCT), frequently used analgesic, promoted by electro-oxidation (EOX), goethite catalyzed electro-Fenton (GEF) with goethite, ozonation and electro-peroxone (E-peroxone) was investigated. The degradation efficiency of the processes was evaluated considering the decay of PCT versus time. All the processes showed pseudo-first order character for PCT degradation. kobs values, at optimum conditions for an individual process, were defined as 0.0022, 0.0029, 0.0870 and 0.1662 min<SUP>-1</SUP> for EOX, GEF, ozonation and E-peroxone processes, respectively. Where EOX and GEF processes showed poor degradation efficiencies, novel E-peroxone process provided complete removal of PCT. The degradation of the PCT would mostly occur by OH· and molecular O₃ due to the higher rate constants achieved at E-peroxone and ozonation. Conversely, with lower kobs values gained at EOX, hydroxyl radicals would not contribute noticeably to the PCT degradation. In GEF process, due to relatively lower OH· production rate, lower kobs values were obtained for the degradation of PCT. The formation of reaction intermediates, aromatics and carboxylic acids, was also determined in this study.

Finite element study on composite slab-beam systems under various fire exposures

Burak K. Cirpici,Suleyman N. Orhan,Turkay Kotan 국제구조공학회 2020 Steel and Composite Structures, An International J Vol.37 No.5

This paper presents an investigation of the thermal performance of composite floor slabs with profiled steel decking exposed to fire effects from floor. A detailed finite-element model has been developed by representing the concrete slab with steel decking under of it and steel beam both steel parts protected by intumescent coating. Although this type of floor systems offers a better fire resistance, passive fire protection materials should be applied when a higher fire resistance is desired. Moreover, fire exposed side is so crucial for composite slab systems as the total fire behaviour of the floor system changes dramatically. When the fire attack from steel parts, the temperature rises rapidly resulting in a sudden decrease on the strength of the beam and decking. Herein this paper, the fire attack side is assumed from the face of the concrete floor (top of the concrete assembly). Therefore, the heat is transferred through concrete to the steel decking and reaching finally to the steel beam both protected by intumescent coating. In this work, the numerical model has been established to predict the heat transfer performance including material properties such as thermal conductivity, specific heat and dry film thickness of intumescent coating. The developed numerical model has been divided into different layers to understand the sensitivity of steel temperature to the number of layers of intumescent coating. Results show that the protected composite floors offer a higher fire resistance as the temperature of the steel section remains below 60℃ even after 60-minute Standard (ISO) fire and Fast fire exposure. Obtaining lower temperatures in steel due to the great fire performance of the concrete itself results in lesser reductions of strength and stiffness hence, lesser deflections.

Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality

Filiz, Kosar A.,Levent, Dalar,Emel, Eryuksel,Pelin, Uysal,Turkay, Akbas,Aybuke, Kekecoglu The Korean Academy of Tuberculosis and Respiratory 2016 Tuberculosis and Respiratory Diseases Vol.79 No.3

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and $PaO_2/FIO_2$ levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

Characteristics of Active Tuberculosis Patients Requiring Intensive Care Monitoring and Factors Affecting Mortality

( Kosar A. Filiz ),( Dalar Levent ),( Eryuksel Emel ),( Uysal Pelin ),( Akbas Turkay ),( Kekecoglu Aybuke ) 대한결핵 및 호흡기학회 2016 Tuberculosis and Respiratory Diseases Vol.79 No.3

Background: One to three percent of cases of acute tuberculosis (TB) require monitoring in the intensive care unit (ICU). The purpose of this study is to establish and determine the mortality rate and discuss the causes of high mortality in these cases, and to evaluate the clinical and laboratory findings of TB patients admitted to the pulmonary ICU. Methods: The data of patients admitted to the ICU of Yedikule Chest Diseases and Chest Surgery Education and Research Hospital due to active TB were retrospectively evaluated. Demographic characteristics, medical history, and clinical and laboratory findings were evaluated. Results: Thirty-five TB patients (27 males) with a median age of 47 years were included, of whom 20 died within 30 days (57%). The Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were significantly higher, and albumin and PaO2/FIO2 levels were significantly lower, and shock, multiple organ failure, the need for invasive mechanical ventilation and drug resistance were more common in the patients who died. The mortality risk was 7.58 times higher in the patients requiring invasive mechanical ventilation. The SOFA score alone was a significant risk factor affecting survival. Conclusion: The survival rate is low in cases of tuberculosis treated in an ICU. The predictors of mortality include the requirement of invasive mechanical ventilation and multiple organ failure. Another factor specific to TB patients is the presence of drug resistance, which should be taken seriously in countries where there is a high incidence of the disease. Finding new variables that can be established with new prospective studies may help to decrease the high mortality rate.

Comparison of Metabolic and Anatomic Response to Chemotherapy Based on PERCIST and RECIST in Patients with Advanced Stage Non-small Cell Lung Cancer

Ordu, Cetin,Selcuk, Nalan A.,Akosman, Cengiz,Eren, Orhan Onder,Altunok, Elif C.,Toklu, Turkay,Oyan, Basak Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.1

Background: The aim of this study was to explore the prognostic role of metabolic response to chemotherapy, determined by FDG-PET, in patients with metastatic non-small-cell lung cancer (NSCLC). Materials and Methods: Thirty patients with metastatic NSCLC were analyzed for prognostic factors related to overall survival (OS) and progression free survival (PFS). Disease evaluation was conducted with FDG-PET/CT and contrast-enhanced CT prior to and at the end of first-line chemotherapy. Response evaluation of 19 of 30 patients was also performed after 2-3 cycles of chemotherapy. Morphological and metabolic responses were assessed according to RECIST and PERCIST, respectively. Results: The median OS and PFS were 11 months and 6.2 months, respectively. At the end of first-line chemotherapy, 10 patients achieved metabolic and anatomic responses. Of the 19 patients who had an interim response analysis after 2-3 cycles of chemotherapy, 3 achieved an anatomic response, while 9 achieved a metabolic response. In univariate analyses, favorable prognostic factors for OS were number of cycles of first-line chemotherapy, and achieving a response to chemotherapy at completion of therapy according to the PERCIST and RECIST. The OS of patients with a metabolic response after 2-3 cycles of chemotherapy was also significantly extended. Anatomic response at interim analysis did not predict OS, probably due to few patients with anatomic response. In multivariate analyses, metabolic response after completion of therapy was an independent prognostic factor for OS. Conclusions: Metabolic response is at least as effective as anatomic response in predicting survival. Metabolic response may be an earlier predictive factor for treatment response and OS in NSCLC patients.